Different collagenase delivery for Dupuytren disease in public hospitals

**Background**: The delivery protocol of collagenase Clostridium histolyticum (collagenase) injection for Dupuytren’s disease is variable, due to limited evidence for any one approach and widespread ‘off-label’ delivery occurring in Australia. As such, this preliminary study aimed to assess whether...

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Main Authors: Jessca A Paynter, Vicky Tobin, James CS Leong, Warren M Rozen, David J Hunter-Smith
Format: Article
Language:English
Published: Australian Society of Plastic Surgeons 2020-09-01
Series:Australasian Journal of Plastic Surgery
Online Access:https://doi.org/10.34239/ajops.v3n2.163
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author Jessca A Paynter
Vicky Tobin
James CS Leong
Warren M Rozen
David J Hunter-Smith
author_facet Jessca A Paynter
Vicky Tobin
James CS Leong
Warren M Rozen
David J Hunter-Smith
author_sort Jessca A Paynter
collection DOAJ
description **Background**: The delivery protocol of collagenase Clostridium histolyticum (collagenase) injection for Dupuytren’s disease is variable, due to limited evidence for any one approach and widespread ‘off-label’ delivery occurring in Australia. As such, this preliminary study aimed to assess whether different collagenase delivery protocols for treating Dupuytren’s disease have an impact on effectiveness and safety. It was hypothesised that different collagenase delivery would affect outcomes. **Methods**: This preliminary, prospective study included a consecutive cohort of adult patients with Dupuytren’s disease being treated with collagenase within two Australian public hospitals to determine whether different collagenase delivery protocols impact on effectiveness and safety. The therapeutic effect was measured objectively using the total passive extension deficit (TPED), clinical success and clinical improvement. Three patient-reported outcome measures (PROMs) were used: Unité Rhumatologique des Affections de la Main (URAM), the Southampton Dupuytren’s Scoring Scheme and the Canadian Occupational Patient-Specific Functional Scale (PSFS). **Results**: The delivery of collagenase was variable at both clinics. The number of patients treated with collagenase at Institute I and Institute II was 49 and 18, respectively. Clinical success was achieved in 42 per cent of the Institute I and 35 per cent of the Institute II cohort. A statistically significant reduction in all three PROMs was observed for both cohorts. No significant differences between effectiveness (clinical success, clinical improvement, TPED, PROMs) or safety was found when comparing the two cohorts. **Conclusion**: The delivery of collagenase was variable at Institutes I and II, but these differences did not appear to impact the effectiveness or safety of collagenase delivery.
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spelling doaj-art-7bcfe477381440fbb0d622e2405b044e2025-08-20T02:39:26ZengAustralian Society of Plastic SurgeonsAustralasian Journal of Plastic Surgery2209-170X2020-09-013210.34239/ajops.v3n2.163Different collagenase delivery for Dupuytren disease in public hospitalsJessca A PaynterVicky TobinJames CS LeongWarren M RozenDavid J Hunter-Smith**Background**: The delivery protocol of collagenase Clostridium histolyticum (collagenase) injection for Dupuytren’s disease is variable, due to limited evidence for any one approach and widespread ‘off-label’ delivery occurring in Australia. As such, this preliminary study aimed to assess whether different collagenase delivery protocols for treating Dupuytren’s disease have an impact on effectiveness and safety. It was hypothesised that different collagenase delivery would affect outcomes. **Methods**: This preliminary, prospective study included a consecutive cohort of adult patients with Dupuytren’s disease being treated with collagenase within two Australian public hospitals to determine whether different collagenase delivery protocols impact on effectiveness and safety. The therapeutic effect was measured objectively using the total passive extension deficit (TPED), clinical success and clinical improvement. Three patient-reported outcome measures (PROMs) were used: Unité Rhumatologique des Affections de la Main (URAM), the Southampton Dupuytren’s Scoring Scheme and the Canadian Occupational Patient-Specific Functional Scale (PSFS). **Results**: The delivery of collagenase was variable at both clinics. The number of patients treated with collagenase at Institute I and Institute II was 49 and 18, respectively. Clinical success was achieved in 42 per cent of the Institute I and 35 per cent of the Institute II cohort. A statistically significant reduction in all three PROMs was observed for both cohorts. No significant differences between effectiveness (clinical success, clinical improvement, TPED, PROMs) or safety was found when comparing the two cohorts. **Conclusion**: The delivery of collagenase was variable at Institutes I and II, but these differences did not appear to impact the effectiveness or safety of collagenase delivery.https://doi.org/10.34239/ajops.v3n2.163
spellingShingle Jessca A Paynter
Vicky Tobin
James CS Leong
Warren M Rozen
David J Hunter-Smith
Different collagenase delivery for Dupuytren disease in public hospitals
Australasian Journal of Plastic Surgery
title Different collagenase delivery for Dupuytren disease in public hospitals
title_full Different collagenase delivery for Dupuytren disease in public hospitals
title_fullStr Different collagenase delivery for Dupuytren disease in public hospitals
title_full_unstemmed Different collagenase delivery for Dupuytren disease in public hospitals
title_short Different collagenase delivery for Dupuytren disease in public hospitals
title_sort different collagenase delivery for dupuytren disease in public hospitals
url https://doi.org/10.34239/ajops.v3n2.163
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